الفهرس 
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Abstract
SUMMARY
Nosocomial infections occur worldwide, both in the developed and developing world. They are a significant burden to patients and public health. They are a major cause of death and increased morbidity in hospitalized patients. They may cause increased functional disability and emotional stress and may lead to conditions that reduce quality of life. Psychiatric patients have been found to suffer from a number of infections in a higher frequency than other populations, and the prevalence of infections in psychiatric patients may vary substantially among countries these are because, psychiatric patients have an increased rate of physical illnesses. Distressingly, psychiatrists fail to recognize these comorbid medical illnesses in nearly half of all cases. All too often, the physical illness may be causing or exacerbating the psychiatric symptoms. Furthermore, the psychiatric condition itself and iatrogenic complications of medication or other treatments can result in serious medical pathology otherwise; psychiatric patients don’t receive adequate medical care.
Aim of the Study:
This study was aiming to assessing nosocomial infection control measures in psychiatric inpatient.
This aim was achieved through answering the following questions
1- What are the health personnel practices, knowledge and attitude regarding to infection control measures?
(Health personnel include psychiatrists and nurses) and housekeepers.
2- What are the patient’s behaviors related to infection control? 3- What are the available facilities in the patient’s environment?
Research hypothesis:
As the psychiatric inpatients deals very little with invasive procedures, therefore, they may neglect infection control measures.
Research setting:
This study was conducted at the inpatients wards, in the institute of Psychiatry affiliated to Ain Shams University Hospitals.
Subjects of the study:
The subjects of the present study included:
1) sixty patients during their admission under the following inclusion criteria:
• Age range: 20-60 years.
• Sex: both sexes (30 males and 30 females).
• Have different psychiatric disorders.
2) Fifty psychiatric nurses working in inpatients with different ages.
• Qualification: diploma and highly qualified nurses.
• Experience: from <5 – 10years.
3)Thirty psychiatrists working in inpatient with different age.
• Qualification: bachelor and master degree.
• Experience: from <5-10 years.
4)Twenty housekeepers with different ages and experience.
Tools of data collection:
Data were collected using the following tools:
1- An interviewing questionnaire of 3 parts to assess the knowledge of psychiatric health personnel regarding to the infection control measures:
The first part: Socio-demographic characteristics interview questionnaire
The second part: Questionnaire to assess knowledge.
The third part: Questionnaire to assess practice & attitude.
2- Observational check list to assess practices of psychiatric health personnel regarding to the infection control measures.
3- Observational checklist for patient’s behaviors related to infection control measures.
4- Observational check list for patient’s environment.
The findings of the present study reached to the following conclusion:
• The patients in the age group 47and above and low socioeconomic level constitute the highest percentage among psychiatric inpatients.
• Schizophrenia was the commonest psychiatric disorders while diabetes mellitus was the most common medical illness.
• High percentage of duration of hospitalization ranged from 1-2 months.
• Most common nosocomial infection between psychiatric patients was respiratory tract infection.
• Little invasive procedures done in psychiatric inpatient
• Majority of health personnel was didn’t receive training in infection control measures so; they have deficit in knowledge , practice and attitude regard to nosocomial infection measures.
Recommendations
Based on the present study, the following recommendations can be drawn:
1) Implementation of infection control program for all health
personnel is very important in psychiatric inpatient.
2) Admission policies: Guidelines for admission should be
established regarding to medical illnesses.
3) Screening and treatment protocols: Screening protocols for
new admits should be established. In an effort to identify
previously undiagnosed physical diseases (diabetes,
hypertension, thyroid disease) and to establish baseline
laboratory data prior to initiating antipsychotic
medications .
4) Regular in-service training for staff members, including
nurses, mental health technicians, admission personnel as
well as psychiatrists, can improve an institution’s overall
familiarity and comfort levels in dealing with patients with
medical disorders and infectious diseases.
4) increased patient safety, and the avoidance of unnecessary
expense .
5) Physical examination must be done adequately before and
during patient admission to detect any co-morbidity which
may interact with psychiatric diagnosis.
6) With the increase of microorganism resistant antibiotics,
there should be continuous monitoring of the appropriate
use of antibiotics.
7) Isolation of patients with known infection